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Republicans in Congress fumbled in the big Obamacare game

Deseret News (UT)

Republicans in Congress blew a huge lead in the last seconds of the 2017 Affordable Care Act bowl game. As the whole nation watched, they fumbled repeal and replace in spectacular fashion. Incredible as it is, after seven years of trashing Obamacare, Republicans had not developed an alternative. No surprise that at crunch time, when the quarterback called the play, the guys on the line of scrimmage went the wrong direction.

The referee (the Senate parliamentarian) recently ruled time has almost run out because Congress' authority to amend the Affordable Care Act (ACA) through the reconciliation process will expire Sept. 30, 2017. After September, Senate Republicans cannot act with a simple majority. They will need 60 votes - meaning several Democrat votes. Not going to happen.

Since its inception, Republicans have broadcast the ACA's many ills - it's a job killer; insurance premiums will skyrocket; the individual mandate is unconstitutional; employers would drop health insurance for employees; it's a budget-buster. Indeed, some of these have proved to be all too true.

However, many features of Obamacare became very popular: Parents' policies cover adult children until age 26; pre- existing conditions can't be considered in pricing health insurance; underwriting based on age is sharply limited; over 10 million Americans receive generous subsidies through the federal marketplace, and Medicaid was expanded in most states with the feds initially bearing 100 percent of the cost. What's not to like? The consumer- friendly features resonated far more strongly with the public than did its disadvantages.

Congressional Republicans oppose Obamacare for many reasons. Among the foremost is that the ACA is very expensive. It's helping to drive up our national debt, which just exceeded a staggering $20 trillion.

This country is so far in debt it's unlikely we can ever get out. At the current tepid economic growth rate, tax revenue will lag far behind federal government expenditures. No politician dares touch Social Security, Medicare and other "entitlements." We lack the national will to cut popular programs that are debt-financed.

What if war, natural catastrophe or financial meltdown were to require the U.S. to raise great sums of money? Could we do it? How will we pay interest on all that debt if interest rates increase? Unless we change soon, the U.S. may suffer the fate of Greece, Spain, Portugal and some developing countries, and we, too, will be forced to adopt strict austerity measures, such as cutting social entitlements and government pensions.

Back to Congress. Reducing the deficit is job No. 1 for many Republican members of Congress. That's why many of them ran for office. That's why some of them shut down the government. That is why some won't vote to raise the debt ceiling without offsetting budget cuts.

Argue with their priorities and their methods, but they speak an essential truth, one most citizens have lost sight of. We can't keep the promises we've made to all the beneficiaries of federal government largesse, let alone pay off our debt. This is a primary driver of why many Republicans have sworn to reverse the many entitlements in the Affordable Care Act - to avoid drowning in debt.

In the repeal-and-replace debate, those Congressional Republicans who are sincerely concerned about our government's financial future did not hold the mounting deficit up to the nation as an essential reason to undo Obamacare entitlements. They did not communicate what they fervently believe. Not surprisingly, they received little support.

There is a lot to criticize about the plans Republicans put forward to replace the ACA. The proposed changes were too sudden and too hurtful to millions of people who receive help from the ACA. Millions who had gone on Medicaid would lose it. There was too little time to phase in a transition. Both the House and Senate plans had very little appeal.

Republicans lost the repeal- and-replace game because they didn't have a game plan. But they also lost it because they didn't articulate to their fans what was at stake in the game. Our national debt is a serious threat to our country. Give credit to those members of Congress who are trying to do something about it.

Greg Bell is the current president and CEO of the Utah Hospital Association. He is the former Republican lieutenant governor of Utah.